Aeronca Aviators Club Membership Application

Aeronca Champ, Chief, Sedan, L-3 (O-58), L-16, Defender, C-2, C-3, Models 50, 65, series K et al. We promote these capable and historic aircraft through their preservation and maintenance, and celebrate their History.

The Aeronca Aviators Club welcomes all owners, pilots and enthusiasts of these fine aircraft.

	Renewal - Member ID: [New Applicants leave blank] Renewing Members need only enter ID, Name and e-mail, unless something else has changed.
Home Page	--------- First -------- -----------Last-----------
* Name:	Spouse:
Addr:
Addr:
City:	St/Prov: Zip/PC:
Country:	[Outside USA only] :
Home Tel:	Work Tel:
* e-mail:
Aircraft 1:	Model: Year: Tail #
Aircraft 2:	Model: Year: Tail #
Aircraft 3:	Model: Year: Tail #
Comments:

Member Contact Information Privacy Policy: It is Club policy to deny requests for Member contact information. However, there is a need for members to contact each other for model-specific issues from time to time. To assure your right to privacy yet fill the need for intra-Club communication, we are implementing an "opt-in" program. To be available to other members, please check below: I agree to allow the Aeronca Aviators Club to release the information checked below to current Club members: Home Telephone Number (as listed above) or special number: Work Telephone Number (as listed above) or special number: Email Address (as listed above) or special address:

Due to the huge rise in the cost of processing credit cards, we are forced to add a $2 surcharge to the dues; this is regardless of the length of membership/renewal. Thanks for understanding.
Select Membership:	U.S. 1 year: $41 ($39 plus $2 C.C. surcharge) 2 years: $76 ($74 plus $2 C.C. surcharge) 3 years: $111 ($109 plus $2 C.C. surcharge) Int'l: 1 year: $46 ($44 plus $2 C.C. surcharge) 2 years: $85 ($83 plus $2 C.C. surcharge) 3 years: $127 ($125 plus $2 C.C. surcharge) [Int'l memberships are outside U.S. based on mailing address and sent via Air Mail]
	Visa, Discover, Mastercard only
Credit Card Number:	- Expires: /

..or..